Introduction

Opportunities to obtain food are influenced byphysical, socio-cultural, economic and policyfactors at both micro and macro levels, theconstellation of which is broadly referred to as thefood environment. The retail food environment can becharacterised by physical attributes such as thedensity, diversity and distribution of food storeswithin an area, often at the neighbourhood or censustract level (Glanz et al, 2005). When foodenvironments are assessed in terms of access tonutritious foods, it is these geography-basedmetrics – density, diversity and distribution – thatare examined in terms of where supermarkets (proxiesfor access to more nutritious foods) and conveniencestores (proxies for less nutritious food access) arelocated, and extrapolated to the overall‘healthfulness’ of a neighbourhood food environment.Proximity to a supermarket, and thereby proximity toa wider array of foods, is often considered apositive feature of a neighbourhood, while theabsence of a supermarket, or the ubiquity ofconvenience stores, is perceived as a negativeneighbourhood feature (Cameron et al, 2010).

These features of the retail food environment are butone aspect of the broader food environment, focusingon the choice, availability and cost of food within,and among, food outlets. Research strongly suggeststhat the structure and organisation of theneighbourhood or community food environment mightinfluence food purchasing patterns and,subsequently, diet-related health outcomes (Thompsonet al, 2013; Richardson et al, 2014). The rise inadverse nutrition-related health conditions now seenat a population level – such as cardiovasculardisease, diabetes and obesity – is now wellunderstood to be a combination of individual andenvironmental-level influences (Larson et al, 2009).Individual factors include genetics and eatingbehaviour; environmental factors include, amongothers, public policy and corporate practices.Increasingly, food environment research focuses onenvironmental factors to uncover the broadsocioeconomic mechanisms that have led topopulation-level shifts in health outcomes. Althoughstudies exploring behaviour and consumption patternsamong individuals were the focus of much research inthe past, it is these environmental-level factorsand their influence on the social determinants ofhealth that are of increasing interest to foodenvironment researchers (Egger and Swinburn, 1997).Emphasis on environmental factors may be based onconsiderations that it is more sustainable andcost-effective to change food and activity spacesrather than the behaviour of the broader population(Kurtz, 2013).